Evaluating the Effects of Denmark’s New Tobacco Control Act on Young People’s Use of Nicotine Products: A Study Protocol of the §SMOKE Study
Abstract
:1. Introduction
1.1. The Legislation
1.2. §SMOKE–A Study of Tobacco, Behavior, and Regulations
1.2.1. Increased Tobacco Prices
1.2.2. Point-of-Sale (POS) Display Ban
1.2.3. Plain Packaging
2. Materials and Methods
2.1. Study Design
2.2. Timing of Data Collection
2.3. Study Sample
2.4. Sample for Baseline Survey
2.5. Data Collection Procedure
2.6. The Questionnaire
2.7. Demographic Information from Registers
2.8. Data Analysis
- (1)
- The prevalence of smoking and use of specific tobacco and nicotine products between baseline and follow-up surveys in the subsequent years, including dual and multiple product use;
- (2)
- Increased tobacco prices, i.e., smoking intensity, transition from daily to occasional smoking or no smoking, quitting attempts and cessation, effects in subgroups;
- (3)
- POS display ban, i.e., perceived availability of products, brand awareness, smoking norms, temptation to buy products, and changes in attitudes towards smoking;
- (4)
- Plain packaging, i.e., package appeal, noticing packages, covering up packages.
2.9. Weighting
3. Discussion
Methodological Issues
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Legislations | Details | Came into Effect |
---|---|---|
First increase in tobacco prices | The average price of a pack (20 PCS) of cigarettes increased from 40 DKK/5.35 EUR to 55 DKK/7.36 EUR (37.5% increase) | 1 April 2020 |
Menthol flavor ban (Tobacco Products Directive) | Ban on cigarettes and RYO tobacco with a characterizing flavor of menthol | 20 May 2020 |
Smoke-free school hours | No smoking during the school day in primary school, even outside school premises | 1 January 2021 |
Point-of-sale display ban | No display of tobacco products, herbal products, e-cigarettes, or nicotine products at points of sale in retail outlets | 1 April 2021 |
Ban on flavors other than tobacco and menthol | A proposed ban on flavors other than tobacco and menthol in other tobacco products than cigarettes and RYO (e.g., chewing tobacco, heated tobacco, and shisha/waterpipe) was planned, but this currently awaits a decision by the European Commission | Temporarily suspended |
Smoke-free-school-hours | No smoking during school hours in high schools and vocational schools, even outside school premises | 31 July 2021 |
Second increase in tobacco prices | Increase in the average price of a pack (20 PCS) of cigarettes from DKK 55/EUR 7.36 to DKK 60/EUR 8.02 (9% increase) | 1 January 2022 |
Ban on flavors other than tobacco and menthol in e-liquids | A ban on flavors other than tobacco and menthol in e-liquids used in e-cigarettes | 1 April 2022 |
Plain packaging of all forms of tobacco including cigarettes, RYO tobacco, chewing tobacco, heated tobacco and waterpipe tobacco | Transition period: 1 July 2021 until 1 April | 1 April 2022 |
Plain packaging of e-cigarettes | Transition period: 1 October 2021 until 1 October 2022 | 1 October 2022 |
Definition of tobacco surrogates, including nicotine containing products which are not medically approved for smoking cessation. Tobacco surrogates are in general covered by the same legislation as tobacco products except standardized packaging and the suggested flavor ban. This includes nicotine pouches | 1 July 2022 |
Topics | Indicators |
---|---|
Sociodemographics | Gender, age, highest level of educational attainment, living status (alone, with parents, etc.) |
Quality of life | Quality of life, physical and mental health, and well-being |
Cigarette use | Current smoking status, smoking frequency and quantity, age at regularly smoking, flavor additives, quit attempts and intentions, intention to smoke (again), perception of smoking as acceptable, smoking in the family and among relatives |
Other tobacco and nicotine products | Products: E-cigarettes, smoke-free tobacco (e.g., nicotine pouches), water pipe, cigarillos, heated tobaccoTobacco and nicotine use–frequency and type of product, flavor additives, perception of health risk, quit attempts and intentions |
Increased cigarette prices | Where to buy cigarettes, purchase price, factory-made or ROY cigarettes, smokers self-assessed effect of increased price on frequency of smoking, financial stress (shortage of money) |
POS display ban | Notification of visible tobacco products in retail establishments, social media, movies, or the internet in the past month |
Plain packaging | Brand awareness, perceptions of quality, satisfaction, taste, value for money, harmfulness, the appeal of the package, risk for addiction and type of cigarette (‘light’, slim, organic, etc.), concerns about health effects, notification of health warnings |
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Klitgaard, M.B.; Jarlstrup, N.S.; Lund, L.; Brink, A.-L.; Knudsen, A.; Christensen, A.I.; Bast, L.S. Evaluating the Effects of Denmark’s New Tobacco Control Act on Young People’s Use of Nicotine Products: A Study Protocol of the §SMOKE Study. Int. J. Environ. Res. Public Health 2022, 19, 12782. https://doi.org/10.3390/ijerph191912782
Klitgaard MB, Jarlstrup NS, Lund L, Brink A-L, Knudsen A, Christensen AI, Bast LS. Evaluating the Effects of Denmark’s New Tobacco Control Act on Young People’s Use of Nicotine Products: A Study Protocol of the §SMOKE Study. International Journal of Environmental Research and Public Health. 2022; 19(19):12782. https://doi.org/10.3390/ijerph191912782
Chicago/Turabian StyleKlitgaard, Marie Borring, Nanna Schneekloth Jarlstrup, Lisbeth Lund, Anne-Line Brink, Astrid Knudsen, Anne Illemann Christensen, and Lotus Sofie Bast. 2022. "Evaluating the Effects of Denmark’s New Tobacco Control Act on Young People’s Use of Nicotine Products: A Study Protocol of the §SMOKE Study" International Journal of Environmental Research and Public Health 19, no. 19: 12782. https://doi.org/10.3390/ijerph191912782